Just days before the international observance of World AIDS Day December 1, a new report by the government of Washington, D.C., offered some grim statistics. One in 50 people in the nation's capital has AIDS. One in 20 is infected with HIV, the virus that causes AIDS. The city has the highest HIV infection rate in the nation. City officials are calling it a "modern epidemic."

When Washington, D.C. mayor Adrian Fenty came into office last January, he made HIV/AIDS his number one public health priority. He reaffirmed that commitment this week with the release of the city's first annual Epidemiology Report. "It's the first time the District of Columbia government has its own statistics on the infection rate and, most importantly, it will allow us to do something about it."

According to the annual report, 12,428 people reported living with HIV and AIDS in Washington, a city of just under 600,000. The rate of new cases is higher than in cities like New York, Chicago and Detroit.

African Americans constitute 57 percent of the population in Washington, yet 80 percent of those infected are black. Among them is Wesley Carpenter, 56, who says he got the AIDS virus from intravenous drug use and promiscuous sex. He was diagnosed 26 years ago, but has led a relatively normal life with the virus thanks to a daily cocktail of three anti-retroviral drugs, regular medical checkups and participation in an HIV/AIDS support group.

But the former drug addict says he is a changed man. "I'm more spiritually grounded now. Also I like to be an advocate and educate people."

When he speaks to groups in the community, Carpenter talks about how important it is to get tested. "Testing cuts down on the spread of it. How can you start treating something that you don't know about?"

The HIV/AIDS report makes the same point. Late testing is a major problem. In Washington, 70 percent of AIDS cases progressed from HIV to AIDS in less than a year, compared with 39 percent nationally.

Shannon Hader heads the District of Columbia HIV/AIDS Administration, the government agency that published the report. She says the data reveals a complex epidemic involving a diverse range of risk groups. "We have about a third of the infections being transmitted heterosexually, a little less than a third being transmitted among men who have sex with men and probably about 20 percent being transmitted through injection drug use."

Among people who have become infected most recently, heterosexual transmission leads all other risk categories. According to the D.C. report, two-thirds of the newly reported HIV/AIDS cases are among people ages 30 to 49.

Hader says the report gives public health officials a road map that can help them focus the city's response to the epidemic. "They really help us prioritize."

Hader says the report also helps public health officials estimate what services they will need in the future, which, he adds, "actually is a higher volume of services than we have now if we really want to cover this epidemic and do it well."

Hader has a $95 million-budget to do the job, which includes stepping up AIDS awareness and quick HIV-testing programs, and distributing millions of free condoms throughout the city. Over the next several years, Hader expects these and other initiatives will reduce dramatically the rate of new HIV infections, and help Washington, D.C. turn the tide of its AIDS epidemic.